Department of Radiology, Hacettepe University Medical School, Ankara, Turkey.
Eur Radiol. 2015 Mar;25(3):776-84. doi: 10.1007/s00330-014-3477-2. Epub 2014 Dec 3.
To determine effectiveness of coronary artery calcium score (CACS) alone and combined with Systematic Coronary Risk Evaluation (SCORE) in adult patients for significant coronary artery stenosis by using computed tomography coronary angiography (CTCA) as reference standard.
Two thousand twenty-one patients with suspected coronary artery disease (CAD) underwent CACS test and CTCA. Patients were examined with dual-source CT and were grouped according to their age, gender, CACS, and estimated SCORE risk. Coronary plaque existence and degree of stenosis were assessed with CTCA. Sensitivity, specificity, and ROC curves were analyzed.
CACS was the single independent variable in estimating relative risk of critical stenosis and had superior outcome when compared with SCORE risk in logistic regression and ROC curve. Area under the ROC curve was greatest in the interval between 50-59 years. When SCORE was combined with CACS in patients with zero CACS, percentage of significant stenosis increased from 1.4% to 7.0% in patients with high or very high SCORE risk, and decreased to 0.9 % in patients with low or moderate SCORE risk.
CACS combination with SCORE risk predicts coronary artery stenosis. When CACS is zero, CTCA can be performed in patients with high or very high SCORE risk.
通过以计算机断层冠状动脉造影（CTCA）作为参考标准，评估冠状动脉钙评分（CACS）单独和联合系统性冠状动脉风险评估（SCORE）在成年患者中对严重冠状动脉狭窄的有效性。
2021 名疑似冠心病（CAD）患者接受了 CACS 检查和 CTCA。患者采用双源 CT 进行检查，并根据其年龄、性别、CACS 和估计的 SCORE 风险进行分组。通过 CTCA 评估冠状动脉斑块的存在和狭窄程度。分析了敏感性、特异性和 ROC 曲线。
CACS 是估计临界狭窄相对风险的单一独立变量，在逻辑回归和 ROC 曲线中优于 SCORE 风险。ROC 曲线下面积在 50-59 岁之间最大。当 SCORE 与零 CACS 患者的 CACS 联合使用时，高或极高 SCORE 风险患者的显著狭窄百分比从 1.4%增加到 7.0%，而低或中 SCORE 风险患者的狭窄百分比则降至 0.9%。
CACS 联合 SCORE 风险预测冠状动脉狭窄。当 CACS 为零时，可对高或极高 SCORE 风险患者进行 CTCA。
